Perspectives in Disease Prevention and Health Promotion
Alcohol and Violent Death -- Erie County, New York, 1973-1983

Since 1973, Erie County, New York, has evaluated blood samples
for
the presence of alcohol and drugs in all
medical-examiner-investigated
deaths.* Recently, the files of the Erie County Medical Examiner's
Office were examined specifically for blood-alcohol concentrations
(BAC) of persons 15 years of age or older who died within 8 hours
of
injury during 1973-1983.

Erie County, located in the western part of New York, has a
population of approximately 800,000 persons 15 years of age or
older;
the main city in this metropolitan area is Buffalo. A total of
3,293
deaths from unintentional and intentional injuries among persons in
this age group was recorded during this period.** The largest
proportion of deaths (34%) was traffic-related, followed by
miscellaneous injuries (27%), suicides (20%), and homicides (19%).

Fifty-three percent of Erie County's population 15 years of age
or
older is female; 91% is white, and 9% is black (1). However,
approximately 73% (59.0/100,000 population) of the victims were
men,
compared with 27% (20.1/100,000) women. The percentages of men and
women who were intoxicated (0.1 g% BAC or higher) at time of death
were 35% and 22%, respectively. Approximately 81% (34.7/100,000)
of
victims were white, compared with 19% (77.6/100,000) for blacks.
The
percentage of black victims who were intoxicated at time of death
was
41%, compared with 29% for white victims.

For the 1,127 traffic-related fatalities, the percentage of
persons killed who were drivers was 55%, compared with 20% who were
passengers. Twenty-three percent were pedestrians, and 2% were
bicyclists. Over 38% of all these traffic-fatality victims were
legally intoxicated at time of death. Forty-four percent of
drivers
were legally intoxicated at time of death, compared with 33% of
passengers, 30% of pedestrians, and 23% of bicyclists.

Among the 875 fatalities caused by miscellaneous unintentional
injuries, 29% of the victims were legally intoxicated at time of
death. Most of these deaths were caused by falls (6%) and
drownings
(4%). Twenty-one percent of fall victims and 26% of drowning
victims
were legally intoxicated at time of death.

Of the 655 suicide victims, 22% were intoxicated at time of
death. The most common methods of suicide were gunshots (29%),
drug
and/or alcohol overdoses (23%), carbon monoxide poisoning (19%),
and
hanging (14%). The percentages of victims who were intoxicated
were
28%, 17%, 28%, and 23%, respectively.

There were 623 homicide victims, approximately 32% of whom were
intoxicated at time of death. The most common methods of homicide
involved guns (49%), knives (30%), and personal weapons (i.e.,
hands
or feet) (20%). The percentages of victims who were intoxicated
were
44%, 36%, and 17%, respectively.
Reported by E Abel, PhD, P Zeidenberg, MD, S Regan, Research
Institute
on Alcoholism, Office of Alcoholism and Substance Abuse, New York
Div
of Alcoholism and Alcohol Abuse, J Uko, MD, TA Rejent, Erie County
Medical Examiner's Officer, Buffalo, New York; Div of Surveillance
and
Epidemiologic Studies, Epidemiology Program Office, Violence
Epidemiology Br, Office of the Director, Center for Health
Promotion
and Education, CDC.

Editorial Note

Editorial Note: Unintentional injuries are the leading cause of
premature loss of life among Americans, and homicides and suicides
are
fourth (2). The presence of alcohol in victims of homicides,
suicides, and unintentional injuries has been described previously
(3-8). Studies have indicated that medical-examiner data are good
sources of information for epidemiologic surveillance of alcohol in
these victims (4). Several studies have compared victims of
traumatic-injury death to victims of death from other causes and
found
that alcohol is more frequently present among victims of
traumatic-injury deaths (3,5), suggesting that alcohol consumption
may
be a risk factor for violent and traumatic-injury deaths. To
determine the relative risk for traumatic-injury deaths given the
ingestion of alcohol, it will be necessary to collect data on
traumatic-injury deaths among persons who do and do not consume
alcohol.

These data from Erie County show somewhat lower proportions of
alcohol involvement than previous reports of motor-vehicle
fatalities
(3,4,9), nonmotor-vehicle fatalities (4,10) and homicides
(3,4,7,8).
This may result from differences in drinking patterns between Erie
County and other localities previously studied, differences from
study
to study in the BAC considered to be positive, or differences in
the
maximum acceptable time lapse between injury and death. However,
the
proportion of suicide victims in Erie County with positive BACs is
similar to that in previous reports (3,4,8).

CDC. Alcohol as a risk factor for injuries--United States.
MMWR
1983;32:61-2.
*Deaths believed caused by homicide, suicide, or unintentional
injuries occurring in the county.
**Data were incomplete for 13 cases; therefore, totals for each of
the
four categories add to only 3,280.

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